Busloads of physicians seek to revive medmal-reform bill

Frustrated by the failure of a years-long lobbying effort to pressure Congress to enact caps on medical-malpractice lawsuit awards, more than 3,000 doctors are expected to descend on to Capitol Hill tomorrow in a show of force the organizers hope could win over the public — and possibly a few crucial votes in the Senate.

Traveling in about 60 buses from Northeastern and Middle Atlantic states, participants in the Coalition for Accessible Physicians event will gather on the West Lawn of the Capitol for a rally. Some will follow the event with visits to member offices and a trip to the White House to meet with advisers to President Bush.

Ruth Schulze, a New Jersey-based obstetrician-gynecologist who chairs the grassroots group, said the effort is motivated in part by a sense that the lobbying being conducted on their behalf has fallen short.

“There is a large voice of grassroots doctors … who feel, perhaps, less than served by … organized medicine,” Schulze said last week. Schulze is secretary of the Medical Society of New Jersey.

The American Medical Association (AMA) and a plethora of medical specialty societies have pushed hard for caps on lawsuit awards, claiming that escalating malpractice insurance premiums are forcing doctors out of business.

A grassroots movement might prove effective where the AMA and others have not, Schulze said. “The AMA doesn’t speak for all physicians.” Schulze is an AMA member, and the organization has endorsed the rally.

“I felt doing more of the same quietly is not going to get it done,” she said.

Donald Palmisano, a surgeon and attorney who is the immediate past president of the AMA, said the organization would stay the course.

Citing accumulating evidence that caps are leading to lower premiums in certain states, Palmisano said the pressure would increase on opponents of caps to change their position.

The AMA is open to compromise, Palmisano insisted, but has heard no acceptable proposal of “an alternative with evidence that it works.”

Many states, led by California in 1974, have enacted caps on malpractice lawsuits. But others have rejected the approach, especially East Coast states with Democratic-controlled legislatures and governor’s mansions.

In Washington, physicians have well-placed allies — no one more so than Bush. The president has been relentlessly vocal on malpractice award caps, but his backing has not been enough to win the Senate.

The House has passed virtually the same bill numerous times since the Republicans took control in the 1990s — and even passed the measure twice during the 108th Congress.

Recalcitrant Senate Democrats, supported by the trial lawyers’ lobby, have managed to block the bill every time, blaming poor business practices by malpractice insurers for the rising premiums. A few Republicans also oppose caps as an infringement on state regulation of insurance.

Senate Majority Leader Bill Frist (R-Tenn.), a surgeon and staunch supporter of caps, even brought a string of bills targeting specialists to the floor last year in the hopes of drawing attention to the issue but failed to change votes.

Backers have resisted compromises on the most contentious element of the legislation: a $250,000 cap on noneconomic damages, sometimes called pain-and-suffering” awards. The measure also would cap punitive damages at twice the amount of the non-economic settlement.

Schulze indicated that she and her fellow doctors are flexible.

“The current legislation can certainly be tweaked,” Schulze said. Foremost, she said, a cap as high as $400,000 for noneconomic damages could be enough to reduce premiums. The cap also could be adjusted in the future to reflect inflation or other factors, she added.

Palmisano said that the AMA also views caps up to $400,000 as potentially effective but that the smaller limit would be more beneficial.

The public has not been persuaded, Schulze conceded. “The public … seems to think that the problem is solved,” she said.

Doctors and the groups that represent them have not convinced the public that the malpractice awards paid by insurance companies have an impact of physicians and patients, said Shulze.

The coalition intends to follow tomorrow’s event by providing brochures or other materials in doctors’ offices in the hope of attaining broader public support.

Despite patients’ natural affinity for their individual doctors, physicians widely are perceived as wealthy and not in need of protections, Schulze acknowledged.

Patients — and juries — also tend to sympathize with injured parties, which makes the public susceptible to arguments against capping lawsuit awards, she said.

Shulze added, “The public doesn’t understand the difference between economic and noneconomic damages,” leading many people to believe that the pending legislation would limit the rights of those harmed during treatment to recoup the costs of medical bills, lost pay and other expenses covered by the “economic” category.